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Autologous chondrocyte implantation versus debridement for treatment of full-thickness chondral defects of the knee: an observational cohort study with 3-year follow-up.

Abstract

BACKGROUND

Studies that compare the effectiveness of different cartilage repair treatments are needed to update treatment algorithms.

HYPOTHESIS

Autologous chondrocyte implantation provides greater improvement in overall condition score than does debridement at a minimum of 3 years' follow-up.

STUDY DESIGN

Cohort study; Level of evidence, 3.

METHODS

Cohorts for debridement and autologous chondrocyte implantation each included 58 Cartilage Repair Registry patients who met study criteria. A retrospective analysis was performed on prospectively collected baseline and follow-up data.

RESULTS

Patients in the autologous chondrocyte implantation and debridement groups had similar demographics and chondral lesions at baseline. However, more autologous chondrocyte implantation patients failed a previous debridement or marrow stimulation procedure than did debridement patients. Follow-up outcome assessments were completed by 54 autologous chondrocyte implantation patients and 42 debridement patients. Eighty-one percent of the autologous chondrocyte implantation patients and 60% of the debridement patients reported median improvements of 5 points and 2 points, respectively, in the overall condition score. Autologous chondrocyte implantation patients also reported greater improvements in the median pain and swelling scores than did debridement patients. The treatment failure rate was the same for both autologous chondrocyte implantation and debridement patients. Eighteen autologous chondrocyte implantation patients and 1 debridement patient had at least 1 subsequent operation.

CONCLUSION

Although patients treated with debridement for symptomatic, large, focal, chondral defects of the distal femur had some functional improvement at follow-up, patients who received autologous chondrocyte implantations obtained higher levels of knee function and had greater relief from pain and swelling at 3 years.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    University of Pittsburgh Medical Center, Pennsylvania, USA.

    , , , , , ,

    Source

    The American journal of sports medicine 33:11 2005 Nov pg 1658-66

    MeSH

    Adult
    Cartilage, Articular
    Chondrocytes
    Cohort Studies
    Debridement
    Female
    Femur
    Humans
    Knee Injuries
    Male
    Middle Aged
    Orthopedic Procedures
    Pain
    Range of Motion, Articular
    Retrospective Studies
    Transplantation, Autologous
    Treatment Outcome

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    16093543

    Citation

    Fu, Freddie H., et al. "Autologous Chondrocyte Implantation Versus Debridement for Treatment of Full-thickness Chondral Defects of the Knee: an Observational Cohort Study With 3-year Follow-up." The American Journal of Sports Medicine, vol. 33, no. 11, 2005, pp. 1658-66.
    Fu FH, Zurakowski D, Browne JE, et al. Autologous chondrocyte implantation versus debridement for treatment of full-thickness chondral defects of the knee: an observational cohort study with 3-year follow-up. Am J Sports Med. 2005;33(11):1658-66.
    Fu, F. H., Zurakowski, D., Browne, J. E., Mandelbaum, B., Erggelet, C., Moseley, J. B., ... Micheli, L. J. (2005). Autologous chondrocyte implantation versus debridement for treatment of full-thickness chondral defects of the knee: an observational cohort study with 3-year follow-up. The American Journal of Sports Medicine, 33(11), pp. 1658-66.
    Fu FH, et al. Autologous Chondrocyte Implantation Versus Debridement for Treatment of Full-thickness Chondral Defects of the Knee: an Observational Cohort Study With 3-year Follow-up. Am J Sports Med. 2005;33(11):1658-66. PubMed PMID: 16093543.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Autologous chondrocyte implantation versus debridement for treatment of full-thickness chondral defects of the knee: an observational cohort study with 3-year follow-up. AU - Fu,Freddie H, AU - Zurakowski,David, AU - Browne,Jon E, AU - Mandelbaum,Bert, AU - Erggelet,Christoph, AU - Moseley,J Bruce,Jr AU - Anderson,Allen F, AU - Micheli,Lyle J, Y1 - 2005/08/10/ PY - 2005/8/12/pubmed PY - 2006/1/7/medline PY - 2005/8/12/entrez SP - 1658 EP - 66 JF - The American journal of sports medicine JO - Am J Sports Med VL - 33 IS - 11 N2 - BACKGROUND: Studies that compare the effectiveness of different cartilage repair treatments are needed to update treatment algorithms. HYPOTHESIS: Autologous chondrocyte implantation provides greater improvement in overall condition score than does debridement at a minimum of 3 years' follow-up. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Cohorts for debridement and autologous chondrocyte implantation each included 58 Cartilage Repair Registry patients who met study criteria. A retrospective analysis was performed on prospectively collected baseline and follow-up data. RESULTS: Patients in the autologous chondrocyte implantation and debridement groups had similar demographics and chondral lesions at baseline. However, more autologous chondrocyte implantation patients failed a previous debridement or marrow stimulation procedure than did debridement patients. Follow-up outcome assessments were completed by 54 autologous chondrocyte implantation patients and 42 debridement patients. Eighty-one percent of the autologous chondrocyte implantation patients and 60% of the debridement patients reported median improvements of 5 points and 2 points, respectively, in the overall condition score. Autologous chondrocyte implantation patients also reported greater improvements in the median pain and swelling scores than did debridement patients. The treatment failure rate was the same for both autologous chondrocyte implantation and debridement patients. Eighteen autologous chondrocyte implantation patients and 1 debridement patient had at least 1 subsequent operation. CONCLUSION: Although patients treated with debridement for symptomatic, large, focal, chondral defects of the distal femur had some functional improvement at follow-up, patients who received autologous chondrocyte implantations obtained higher levels of knee function and had greater relief from pain and swelling at 3 years. SN - 0363-5465 UR - https://www.unboundmedicine.com/medline/citation/16093543/Autologous_chondrocyte_implantation_versus_debridement_for_treatment_of_full_thickness_chondral_defects_of_the_knee:_an_observational_cohort_study_with_3_year_follow_up_ L2 - http://journals.sagepub.com/doi/full/10.1177/0363546505275148?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -